Health

Health and Physical Education Class - 8 Government of Nepal Ministry of Education Curriculum Development Center

Publisher: Government of Nepal Ministry of Education Curriculum Development Centre Sanothimi, Bhaktapur © Publisher First Edition : 2016 Revised Edition : 2018 Price : 42/- All rights reserved. No part of this publication may be reproduced, stored in a retrieval system or transmitted, in any other form or by any means for commercial purpose without the prior permission in writing of the Curriculum Development Centre.

Preface The curriculum and curricular materials have been developed and revised on a regular basis with the aim of making education purposeful, practical, relevant and job-oriented. It is necessary to instill the feeling of nationalism, national integrity and democratic spirit in students and equip them with morality, discipline and self- reliance so as to develop in them social and personal skills as well as the basic competencies of language, science, occupation, information and communication technology, environment and health, and life skills. It is also necessary to enable them to appreciate, preserve and promote arts and aesthetics, social norms and val- ues and ideals. Moreover, in order to develop an equitable society, it is necessary to inculcate students with respect for ethnicity, gender, disabilities, languages, re- ligions, cultures and regional diversity. Likewise, education should also help them to be well-informed of human rights and social norms and values so as to make them capable of playing the role of responsible citizens. This textbook has been developed in this form based on the Basic Education Curriculum, 2069 (Grade 8), incorporating the feedback obtained from various schools, workshops and seminars and interaction programmes attained by the teachers, students and parents. This textbook was translated and edited by Min Bahadur Achhami, Madhav Kumar Shreshtha, Prem Prasad Paudel and Laxmi Dhital. In bringing out this text book in this form, the contribution of the Executive Director of CDC Mr.Diwakar Dhungel, Deputy Director Ms Sarala Paudel, Prof. Dr.Ramkrishna Maharjan, Dr.Chitra Ba- hadur Budhathoki, Krishna Prasad Dhakal, Shyamkrishna Bista, Gokarna Thapa and Punam Dangol is highly commendable. Language of this book was edited by Chandra Kanta Bhusal and Madhu upadhaya. Typing was done by Abhaya Shrestha. The layout design of the book was done by Jayaram Kuikel. The illustration of the book was done by Sunil Ranjit and Gautam Manandhar. CDC extends sincere thanks to all those who have contributed in the development and revision of this text book. Textbook is considered as an important tool of learning. Experienced teachers and curios students can use various learning resources and tools to achieve the com- petencies targeted by the curriculum. An attempt is made to make this textbook activity oriented and interested as far as possible. The teachers, students and other stakeholders are expected to make constructive comments and suggestions to make this book a more useful learning material. Government of Nepal Ministry of Education Curriculum Development Centre

Contents S.N. Particular PageNumber Health Unit 1 Human Body 1 Unit 2 Personal Health 15 Unit 3 Nutrition 18 Unit 4 Disease 25 Unit 5 Adolescent's, Sexual and Reproductive Health 38 Unit 6 Drugs, Alcohol and Tobacco 48 Unit 7 Environmental Health 52 Unit 8 Safety and First Aid 59 Unit 9 Family and Community Health 67 Physical Education Unit 1 Exercise 74 Unit 2 Drill 79 Unit 3 Physical Training 80 Unit 4 Yoga 87 Unit 5 Game 94 Unit 6 Athletics 114

Unit Human Body 1 We have studied about the introduction of human body in the previous grades. In this grade, we will study the following aspects of the human body. Circulatory System Circulatory system refers to the process of joint and smooth functioning of the heart, blood and blood vessels in the human body. Circulatory system takes the nutrients, oxygen, hormones and enzymes obtained from different sources to the cells of the body. The blood returns to the heart in order to be purified. The organs such as heart, blood vessels, that are involved in the circulatory system and the blood are described below. The Heart The heart lies little inclined on the left of the chest. Its weight in an adult female is 230 to 280 gram and in an adult male is 280 to 340 grams. The part that separates the right and left part of the heart is called septum. The upper chambers of the heart (superior venacava) (right pulmonary artery) (left pulmonary artery) (right pulmonary veins) (left pulmonary veins) (pulmonary valve) (aortic) (right ventricular valve) (left ventricular valve) (septum) (inferior venacava) Health & Physical Education, Class-8 (aorta) 1

are called atrium and the lower chambers are called ventricle. The inferior venacava and superior venacava open from the right atrium. Similarly, the pulmonary veins open from the left atrium. The Pulmonary artery begins from the right ventricle and aorta begins from the left ventricle. Between right atrium and right ventricle, there lies tricuspid valve. Similarly, between left atrium and left ventricle, there lies bicuspid valve. The functions of the heart are as follows. a. It circulates the pure blood to different parts of the body. b. It sends the impure blood to the lungs in order to purify it. c. It assists to circulate the oxygen and nutrients hormones to different parts of the body. d. It helps to maintain temperature by blood circulation. Blood Vessels The vessels through which the blood flows are called blood vessels. The blood that is pumped by the heart reaches the cells through the blood vessels. The same blood again returns to the heart through the blood vessels. Such types of blood vessels are of three types. They are: arteries, veins and capillaries. Except the pulmonary artery, in all other arteries the pure blood flows and it reaches different parts of the body. The pulmonary artery leads the blood to the lungs for purification. The arteries divide into innumerable capillaries. The capillaries reach the cells. The blood takes the oxygen and nutrients to cells and it takes back carbon dioxide and other toxic elements again to the heart. In this process, the capillaries integrate into veins and through those veins, the blood moves to the heart. Through all the veins, the deoxygenated blood circulates but through the pulmonary veins, oxygenated blood circulates. The Blood The red-coloured liquid in our body is called the blood. In the body of an adult person, the quantity of the blood is approximately five liters. The blood consists of blood cells and plasma. The blood cells are formed in bone marrow. The blood cells are of three types. They are: red blood cells, white blood cells, and platelets. The function of the blood is to take the nutrients, oxygen to the cells and concentrate 2 Health & Physical Education, Class-8

carbon dioxide to the lungs. Similarly, the blood increases the immunity of the body and balances the level of water, minerals, salt and temperature. It takes the hormones to the appropriate parts of the body. Blood Circulation Process The heart functions as a pump in order to circulate the blood to the body parts. The impure blood from the upper part of the body reaches the heart through superior venacava and such blood from the lower part of the body reaches the heart through inferior venacava. Both these venacava take the blood to the right atrium. When the heart relaxes, the blood flows to right ventrical through the tricuspid valve. When the heart contracts, the same blood moves from right ventricle to the lungs through the pulmonary artery. The blood in the lungs reaches the air sacs through the capillaries in it. At that time, the blood gets purified mixing the oxygen and leaving the carbondioxide (Co2) there. The purified blood reaches the left atrium through pulmonary vein. This type of circulation of the blood from the heart to the lungs and from lungs to the heart is also called pulmonary blood circulation. The blood collected at left atrium moves to the left ventricle through the bicuspid valve when the heart relaxes. After the contraction of the heart, the same blood is pumped to all the organs, tissues and cells through aorta. The cells consume the oxygen of the blood and the carbondioxide or other unnecessary elements mixed into the blood. That blood finally moves to the right atrium of the heart through capillaries to veins and veins to venacava from different parts of the body. This process is known as systemic blood circulation. Glandular System Gland is a group of special cells that produce enzymes and hormones. The enzymes and hormones produced by the glands affect in digestion, physical activities, etc. Enzymes secreted by exocrine glands do not directly mix into the blood. They secrete enzymes into ducts and reach the necessary parts through ducts. Glands such as salivary glands, sweat gland, pancreas, and stomach are the examples of such glands. Endocrine Glands The hormones secreted by endocrine glands directly mix into the bloodstream and reach the parts of the body through it. The types of such glands are described below. Health & Physical Education, Class-8 3

(Pineal) (Pituitary) (Thyroid) (Parathyroids) (Thymus) (Adrenals) (Pancreas) (Ovary) (Testes) a. Pineal Gland Pineal gland lies at the middle of the brain. Its size is bigger in the early years after birth and gradually becomes smaller when we become adult. This gland is reactive to brightness. It produces the hormone melatonin more in darkness than in the brightness. Because of this, we feel like sleeping at night. In the case of other animals, it creates the sensation of hibernation. Due to this hormone, the birds know the time. b. Pituitary Gland Pituitary gland is located at the center of the skull. This gland controls all other glands. Therefore, this gland is also called master gland. It produces growth hormone and this hormone assists in the growth of our body. In case of low production of this hormone, our body height cannot increase. If there is excessive secretion of this hormone, there may be unnatural growth. This type of disease condition is known as gigantism. Pituitary gland assists in the development of ova in females and also assists the breasts to activate milk secretion during pregnancy. 4 Health & Physical Education, Class-8

c. Thyroid Gland This gland is situated both in the right and the left side of the anterior part of the neck. They are two in number, one in each side. This produces the hormone named thyroxine. It also produces calcitonin. The size of this gland may grow abnormally in case of lack of iodine. This case is called goiter. d. Parathyroid Gland Parathyroid gland remains at the back of thyroid gland and four in number. It produces the hormone called parathormone. It strengthens the bones by balancing the level of calcium and phosphorous. In case of lack of this hormone, the disease called muscle tetany (the abnormal contraction of muscles) may take place. If this hormone is produced in excess, stone may be formed in the ureter and may result in unnatural growth of bones. e. Thymus Gland Thymus gland grows until adulthood and becomes thinner along with ageing. This gland is located at the back of sternum in the chest. Its weight remains almost 10 grams in childhood, 35-40 grams in adulthood and 15 grams in old age. It secretes the hormone called thymosin. The main function of this gland is to produce lymphocytes. The lymphocytes produce antibody and increases immunity. f. Adrenal Gland Adrenal gland remains at the top of each kidney. It produces the hormone corticoids at the outer layer. If this hormone is produced in excess, then symptoms such as increment of sugar level in blood, dehydration and continuous weight loss may be noticed. The inner part of this gland, medulla, secretes the hormone adrenaline. The main function of this is to increase the rate of heart beat, blood pressure, and blood circulation in muscles. g. Pancreas Pancreas is situated at the back of the stomach. This gland is also known as a mix gland. While producing digestive hormone, this gland functions as an exocrine gland. It functions as an endocrine gland while producing glucagone and insulin. Insulin balances the glucose level in the blood. If the glucose level rises, more glucose can be seen in urine. This disease condition is known as diabetes. Health & Physical Education, Class-8 5

h. Gonads This gland consists of two other glands specific to males and females. They are: ovaries in females and testes in males. They are heterocrine glands which secrete hormone and gametes. i. Ovary This gland is in females only. Two of this gland remains on the right and left sides of uterus. This gland secretes the hormones named oestrogen and progesterone. Oestrogen enlarges size of breasts, grows pubic hair, and activates ovaries to produce ova. Progesterone creates favourable conditions for fertilized ova to be alive. It assists the zygote to grow and activate breast to produce milk. This hormone is responsible for menstruation in females. ii. Testis This gland is in males only and has two small parts. It produces hormone called testosterone. Due to this hormone, beard and other hairs grow in males. Similarly, this hormone is responsible for the development of hoarse sound in males and increment of size of penis. This hormone activates the testis to produce sperms. The Nervous System The nervous system controls and regulates all the other systems as well as external and internal activities in our body. This system is also known as a mater system. In the nervous sytem, there are neurons and nerve fibres. This system can be divided into three parts as mentioned below. Cell body Cell nucleus axon Nucleus fibers 6 Health & Physical Education, Class-8

a. Central Nervous System b. Peripheral Nervous System Cerebrum c. Autonomic Nervous System Mid Brain A. Central Nervous System Cerebellum The main parts of the central nervous system Pons Varolii are brain and spinal cord. Spinal cord Brain i. The Brain The white-coloured element in the skull is the brain. Its weight in adults is around 1400 grams. It includes hundreds of thousands of neurons. It consists of the following parts. Cerebrum: Cerebrum lies at the top of the brain. It covers the large part of the brain. This part controls and regulates memorizing, arguing, thinking, differentiating, and analyzing. This is also the centre of generating the sensations for warmth, smell, taste, hearing, and viewing. This part of the brain controls the functions of other parts of the brain. This part also activates the muscles and glands of the body. Cerebellum: Cerebellum lies just below the posterior part of cerebrum. It balances the physical movement. It controls and balances the muscular activities while walking and running. This part also delivers the sensations obtained to cerebrum. Mid Brain: Mid brain lies between cerebrum and pons varoli. It delivers the messages obtained from the spinal cord to cerebrum and sends the instructions of the cerebrum to the spinal cord. Pons Varoli: Pons varoli lies between mid-brain and medulla oblongata. It also delivers the messages to and from spinal cord and cerebrum. Health & Physical Education, Class-8 7

Medulla Oblongata: Medulla oblongata lies between pons varoli and spinal cord. It regulates the involuntary functions of the body. The main functions of this part of the brain are to control heartbeat, respiration, blood pressure, swallo wing , salivation, sneezing against pinching, heating, etc. are the examples of reflex actions. Spinal Cord: Spinal cord begins from medulla oblongata. The white soft cord like part that runs along the dorsal side of the body within the vertebral column to the coccygeal bone is referred to as spinal cord. It sends the sensations to the brain and also controls reflex actions. Thirty one pairs of spinal nerves emerge from this cord. These nerves control the functions of internal and external organs. B. Peripheral Nervous System In peripheral nervous system, twelve cranial nerves and thirty one spinal nerves work collectively. The cranial nerves generate from the brain and the spinal nerves generate from the spinal cord. They are spread around various organs of the body. They communicate the sensations to the brain or spinal cords from various organs and vice versa. C. Autonomic Nervous System A number of actions take place in our body, which are beyond our control. Such actions are regulated by autonomic nervous system. This system can be divided into two types as sympathetic and para-sympathetic nervous system. The functions of sympathetic and para-sympathetic nervous system are opposite to each other. The sympathetic nervous system makes the pupils smaller, increases the heartbeat, slows down the digestive system, decreases the amount of urine, and slows the functions of endocrine glands. The para-sympathetic functions just opposite to the actions mentioned above. Reproductive System The process of collective functions of the organs responsible for reproduction is known as reproductive system. It includes both male and female reproductive systems. Both these systems produce gamete, a special type of cell. The male reproduction cell is known as sperm and female reproduction cell is known as ova. Within human reproductive system, the male and female reproductive systems are separately described as below. 8 Health & Physical Education, Class-8

1. Female Reproductive System The female reproductive system is divided into two parts. They are: external genitals and internal reproductive organs. The external genitals are collectively called vulva. We have studied about the external genitals of female reproductive system in our previous classes. Here, we have described about the internal reproductive organs and their functions. (Fallopian Tube) (Uterus) (Cervix) (Ovary) (Vagina) a. Vagina b. Uterus c. Fallopian tube d. Ovaries a. Vagina The muscular tube extending from cervix to the exterior of the body is called vagina. It is soft, greasy and elastic. It is almost 8 to 10 centimeter long. The main functions of the vagina are: receive the penis during sexual intercourse, serve as a conduit for sperm to enter uterus and menstrual flow from the uterus and function as a birth canal during childbirth. b. Uterus Uterus is a vacuum muscular organ. It is 7.5 centimeter long, 5 centimeter wide and 2.5 centimeter thick. The topmost portion of this is fundus, the middle portion is body and the lowest portion is cervix. The walls of the uterus are formed of three Health & Physical Education, Class-8 9

muscular layers. Functions of Uterus i. To regulate menstruation ii. To hold ova after conception. iii. To provide protection and nurturing to fertilized ovum. iv. To grow and develop the embryo. v. To assist in child birth. c. Fallopian Tube There are two fallopian tubes each on both sides of the upper part of uterus. Each one is 10 cm long. The main functions of this part are: hold the egg produced from the ovaries and create conditions for it to get fertilized. Similarly, it also transports the fertilized egg to uterus, and allows the sperms to pass to ampulla from the uterus. d. Ovaries There are two ovaries each on right and left side of the uterus. They include innumerable immature eggs. When the females get into their puberty, then the ovaries produce single matured eggs each month. This process is known as ovulation. The main functions of this part are to produce eggs and the hormones oestrogen and progesterone. follicle cell developing primary follicle Matured follicle Ruptured follicle Ovum released figure; cross-section of ovary (human) 10 Health & Physical Education, Class-8

2. Male Reproductive System The system consisting of male reproductive organs and their anatomical/physiological structure is called male reproductive system. It includes the following organs. (Ureter) (Seminal Vesicle) (Urinal bladder) (Rectum) (Ejaculatory Duct) (Prostate Gland) (Vas Deferens) (Penis) (Epididymis) (Urethra) (Testes) a. Testes b. Epididymis c. Vas Deferens d. Seminal vesicle e. Ejaculatory duct f. Prostate gland g. Urinal bladder h. Urethra i. Penis a. Testes There are two testes in males. They remain hanging in the scrotum (a muscular bag). In each testes, there are 200 to 300 tubules. In each portion, there are seminiferous tubules. The main function of this is to produce sperm and testosterone hormone. Health & Physical Education, Class-8 11

b. Epididymis There are innumerable thin ducts in each testes. These ducts are called seminiferous tubules. The combination of all these tubules makes epididymis. It is in the form of a curve just behind the testes. It includes long and curve type thin ducts and they jointly form a single duct. The main function of this is to form matured sperms and push the sperms towards vas deferens. c. Vas Deferens This part generates from epididymis and ends at ejaculatory duct. They are two in number. This duct is 40 to 45 centimeter long. The main function of this is to pass sperm to ejaculatory duct. d. Seminal Vesicle Seminal vesicles are situated at the back of the urinary bladder. It produces the semen and provides nutrients to the sperms. It stores sperm before ejaculation. e. Ejaculatory duct The duct emerging from seminal vesicle and vas deferens jointly form ejaculatory duct. So, this duct leading from seminal vesicle to prostate gland is named ejaculatory duct. It is almost 2 centimeter long. The main function of this is to pass sperm towards urethra for ejaculation. f. Prostate gland: This gland remains below the urinary bladder. It covers the initial portion of urinary tract. Because of this, in case of enlargement of this gland, there is difficulty in urination. The main function of this is to produce a greasy type of liquid that assists the sperms to move. It helps to neutralize the acidic environment of urethra. g. Urethra: This part expands from the urinary bladder to the end of penis. Its length is almost 18 to 20 centimeter. Urination and ejaculation are the basic functions of urethra. 12 Health & Physical Education, Class-8

h. Penis The penis is formed of erectile tissues. This is of cylindrical shape. It consists of three parts. They are root, body and glans penis. The top of penis is of triangular shape called glans penis. The covering skin at the top of penis is called foreskin. Sexual intercourse, insertion of sperm into the vagina, urination, etc. are the basic functions of penis. Urethra opens of the tip of glans penis. Activity Sketch the figures of female and male reproductive systems and discuss their functions with each other. Summary - The process of simultaneous functions of heart, blood and blood vessels in human body is called blood circulation system. This system takes all the nutrients, oxygen, hormones and enzymes to the cells. - The organs in our body that produce various liquids and hormones are called glands. The system formed of these organs is called glandular system. - The internal and external activities of all systems of our body are controlled and regulated by the nervous system. - The process of collective functions of all the organs that are responsible for reproduction is called reproductive system. Exercises 1. Give very short answer to the following questions. a. What are the organs that take part in blood circulation system? b. What are the types of blood vessels? Write their names. c. Which hormones are produced by thyroid gland? Health & Physical Education, Class-8 13

2. Give short answer to the following questions. a. Write about blood circulation process. b. Write the names of endocrine glands and describe the functions of any two of them. c. Write the functions of the organs of female reproductive system. 3. Draw the figures of the following organs and label them. a. THe Heart b. The brain and spinal cord 14 Health & Physical Education, Class-8

Unit 2 Personal Health Introduction We have to keep all our body parts clean in order to be healthy. Besides this, regular exercise, rest, sleep, recreation, etc. are also necessary. Balanced diet and healthy food along with required amount of water is also necessary. Smoking, alcoholic habits, drug addiction badly affect our health. Similarly, use of cosmetics excessively, consuming, unhygienic food and unsafe sexual behaviour, etc. affect negatively in our health. We can be healthy if we maintain personal hygiene. Ways to Keep Our Body Clean a. We should wash our hands after going to toilet (defecation), after touching dirt, before cooking food and having meal. b. We should clean body parts such as eyes, nose, teeth, ears, neck, skin, genitals, hands and feet regularly. c. We should cut nails, wash clothes, take a bath and comb hair regularly. d. We should use clean water and handkerchief to clean eyes. e. We should take a bath daily. f. We should wear clean clothes that are compatible with summer and winter seasons. g. We shouldn’t take drugs, alcohol and tobacco. h. We shouldn’t walk bare foot and should use separate sandals for toilet. i. Towels, combs, tooth brushes, etc. must not be shared. They should be personal. j. The girl should change underwear and pad used during the period. Health & Physical Education, Class-8 15

Regular Health Check-up Regular health check-up is necessary in order to prevent ourselves from different types of diseases. Various types of bacteria and viruses may enter our body and weaken our immunity power. Therefore, regular health check-up is necessary. We have to consider the following aspects in order to do this. a. We have to make frequent health check-ups to confirm whether the internal organs such as lungs, heart, kidneys, intestines, etc. are functioning properly or not. b. Regular health check-ups are necessary for pregnant women and babies. c. The height and weight of the babies is to be measured regularly. d. The children should be provided with necessary nutrients and timely vaccinations. e. We should make periodic eye check-up. Activity Prepare a list of the activities that your family members carry out in order to keep the body parts clean and share it to your friends in the class. Summary - The process of taking care of various organs of the body in order to keep them clean by the individuals themselves is known as personal health. - The task of the people regularly visiting the health centers in order to confirm the health status of the whole body is known as regular health check-up. 16 Health & Physical Education, Class-8

Exercises 1. Tick (√) the correct alternative from the list. a. What do you mean by personal hygiene? i. Cleanliness for all members of the family ii. Cleanliness for the society iii. Cleanliness for the school iv. Cleanliness for own self b. What different measures should we follow in order to protect our eyes? i. Have eyes checked up frequently ii. Always keep eyes clean iii. Eat green vegetables and yellowish fruits. iv. All of the above c. What do you mean by regular health check-up? i. The check-up to find out the health condition ii. The check-up we make when we are sick iii. The check-up after getting an accident iv. No need of regular health check-up 2. Give short answers to the following questions. a. What are the things we need to be careful for personal health? Write briefly. b. What do we need to do to protect our eyes? Prepare a list of such measures. c. What is the advantage of regular health check-up? Health & Physical Education, Class-8 17

U 3nit Nutrition Nutrition is the entire process by which organisms obtain energy and nutrients from food. Nutrition is essential in order to keep the body fit and healthy. Nutrition is the science related to food. It has close relation with health. It is very much important for physical growth, formation of cells and tissues in the body, repair them accordingly, protect the body, and produce energy as required. Introduction to Malnutrition Malnutrition is the result of the lack or excess of the nutrition necessary for the body. The level of nutrients may be more or less if we don’t take food as required. If people do not take the food available at home in a balanced way or if children are not fed accordingly, they may get malnutrition. The body becomes very much weak during malnutrition so that various diseases may attack it. In order to avoid malnutrition, we have to eat fruits, green vegetables, grains, cereals, meat, fish, milk, curd, etc. in a balanced way. Early treatment of the diseases such as worm, dysentery, diarrhea, tuberculosis, etc. is necessary. Through health education, we have to raise public awareness in regard to increment of food production and control of population growth. Similarly, we have to pay attention to environmental hygiene and undertake periodic health check-up. 18 Health & Physical Education, Class-8

Effects of Malnutrition Marasmus A kind of disease that takes place due to shortage of protein and carbohydrate in children and the people of any age is called marasmus. Mostly this disease is found in the children below five years of age. The common symptoms of this disease are: loss of appetite, weakening of the body, appearance of wrinkles in the face, etc. Similarly, weight loss, slow growth, loose stool, dehydration and thin chest muscles making the ribs easily visible are the other symptoms of marasmus. Milk, fish, meat, grains, etc. are the sources of protein and wheat, maize, millet, potato and other sweet food items are the sources of carbohydrates. To prevent children from marasmus, balance diet is necessary. Preventive Measures a. The child needs to be breast fed only for six months from the birth. After six months, the child must be fed with soft and nutritious food items such as 'Sarbottamlito', fruit juice, grain soup, vegetable soups, 'dalbhat', etc. along with mother’s milk. b. There must be early treatment of various communicable diseases. c. The children should get timely treatment of diseases such as Malaria, Pneumonia, dehydration, etc. d. We should be aware of the disease. 1. Rickets If there is deficiency of Vitamin ‘D’ in food, the body cannot extract calcium and phosphorus which causes poor growth of bones and teeth. This condition is called rickets. In this disease condition, the bones of the legs may be twisted, ribs and forehead may be fronted,bones at wrist and ankles may be swelled. These are the main symptoms of this disease. Health & Physical Education, Class-8 19

Preventive Measures a. We should take the food items that include vitamin D such as yellowish part of egg, fish oil, milk, curd, liver, etc. b. We should eat food items that include calcium and phosphorous such as milk, green vegetables, grains, etc. c. When the sun's rays hit the skin, a reaction takes place that enables skin cells to manufacture vitamin 'D'. d. If necessary, we should consult the nearest health centers and have check-ups. 2. Anaemia Anaemia refers to the deficiency of blood in the body. The red blood cells in the body cannot grow due to the deficiency of iron or vitamin B and vitamin C which ultimately causes anaemia. This disease is usually diagnosed in children and pregnant women. In the case of anaemia, the tongue, skin and inner part of the eyelid changes into red colour and seems paler. Similarly, other symptoms include finger nails changing into white, the extremities becoming weak and frequent rapid respiration. Therefore, the children and pregnant women need to be fed with food items such as liver, fish, meat, milk, curd, green vegetables, leguminous, fruits, etc. Preventive Measures a. We should eat food items such as green vegetables, grains, fish and meat, eggs, dishes of millet, apples, etc. from which we get vitamin C and iron. b. We should visit health centers for check-ups and advice. 3. Night Blindness Night blindness is caused due to the deficiency of vitamin A. Though this disease can be found in the people of any age, most often this is seen in the children under age 5 years and in pregnant women. People with this disease cannot see at night or in dim light. Some of its symptoms are: difficulty to see at night or even at dim light; suffering from diarrhea or measles; dryness, blindness or protrusion of cornea, etc. 20 Health & Physical Education, Class-8

If it is not cured early, the children may completely lose their sight. Preventive Measures a. Children must be fed the food items with vitamin A. b. Eyes must be cared or protected daily. c. Children must be provided with green vegetables, yellowish fruits, milk, curd, egg, liver, etc. d. They must be breast fed regularly for two years from the birth. e. Children above 6 months of age must be given vitamin A capsule at the gap of 6 months. f. We should enhance public awareness towards marasmus through health education. 4. Scurvy Scurvy is a disease caused by deficiency of vitamin C in the body. This disease causes swollen and infected gums. Its symptoms include: continuous bleeding in case of injuries or wounds, appearance of red spots in the body, frequent flu, etc. Preventive Measures a. We should keep ourselves clean and healthy. b. We should take food items that include vitamin C such as amla (hog plum), guava, orange, etc. regularly. c. We should brush regularly and flush out the things trapped in the gums. d. We should take advice from the doctor. e. We should enhance public awareness through health education. Health & Physical Education, Class-8 21

Ways to Manage Balanced Diet from Locally Available Food Items The food items available in our locality are: rice, corn, wheat, millet, buck wheat, beans, soybeans, yellow lentil, potato, radish, green vegetables and fruits. These food items can be divided into three categories based on their function in the body as: i. Energy giving items: Food items that provide energy ii. Growth items: Food items that assist growth iii. Protecting items: Food items that assist building immunity power in the body Balanced diet is the food that includes appropriate amount of the food items from the above mentioned categories. If we take sufficient amount of balanced diet, then we get almost all the required nutrients for our body. We have to take the locally available food items in the balanced way. Due to the lack of knowledge about it, people take imbalanced diet. For example, if we take only lentil with rice, then we cannot get the nutrients to protect our body. Similarly, if we take spinach or other vegetables with rice or roti, then we cannot get the nutrients that assist growth of our body. Therefore, we can make balanced food that includes rice or rice made up of ground corn pieces (Chyakhla), wheat, millet, corn, lentil, dhido, beans and grains, green vegetables, fruits, etc. We get protein from milk and carbohydrate from potato. It may be difficult to include many types of food items in every single meal. Therefore, we can get all types of nutrients needed for our body if we take different types of food items in the morning, day or evening meals. So, we have to manage balanced diet taking those food items that are available at the local level. Ways to Protect Nutrients while Cooking Food items naturally contain nutrients but if we don’t cook properly, they may be destroyed. Therefore, we have to be very much careful in order to protect the nutrients while cooking.The food should be covered or closed while cooking. We should not mix the cooked and uncooked food. The kitchen and store room at home must be safe and spacious. We should not over-peel potatoes and sweet potatoes. Food items should not be over- fried or oil-fried. Green vegetables such as spinach 22 Health & Physical Education, Class-8

should be washed before chopping into pieces. Soda must not be added in the food because it destroys the nutrients. Ghee should not be over-heated. The green vegetables should not be cut into smaller pieces. Demerits of Processed Food There is increasing use of processed or junk food items in and around our schools. Such items include noodles, potato chips, biscuits, sweets, dried meat or fruit dishes, dalmoth or bhujiya, etc. Our health deteriorates if we consume such items in excess. In order to protect such items, the manufacturers use various types of chemicals. In a long run, food items gradually lose nutrients. This ultimately worsens our health instead of supplying necessary nutrients to our body. Though they taste good and sweet, the necessary vitamins, proteins or nutrients in such items may be destroyed. Use of new types of colours and uncleanliness in the industries causes direct harm in human health. The disadvantages of processed food can be listed as below. a. Such food items cannot supply all necessary nutrients to our body. b. Inedible items such as colours, yeast, tasting powder, etc. are mixed in the processed foods that are harmful to human health. c. The readymade food items may not have expiry date on their cover so they may be harmful after a long time. d. Due to the consumption of such food items, we may suffer from the diseases such as high blood pressure, jaundice, diarrhea, etc. e. This may badly affect physical and mental development of children and also weaken their memory power. f. Such readymade food items may be of low quality. Activity Classify the food items that are found around your locality into three categories as those that assist growth, those that provide energy and those that protect the body. Health & Physical Education, Class-8 23

Summary - Insufficiency in the supply of nutrients needed for the body is known as malnutrition. - If the food items available in the local context are properly collected and utilized, this becomes a balanced diet. - We can get different nutrients in locally available foods as well. - A kind of disorder that appears in children due to deficiency of carbohydrates and protein in the body is called Marasmus. - The disease caused by deficiency of vitamin C is Scurvy. It causes swollen and infected gums. - Anaemia is a kind of disease caused by deficiency of blood in the body due to various reasons. - We have to be careful on the ways of protecting natural nutrients while preparing food. Exercises 1. Give short answers to the following questions. a. What is malnutrition? b. Make a list of nutrients necessary for our body. c. What causes marasmus? d. Describe the ways to protect the nutrients. e. Write any four ways to avoid scurvy. f. Make a list of the symptoms of anaemia. g. Whataretheharmsofprocessed/ready-madefooditems?Preparealistof such harms. 2. Give very short answer to the following questions. a. Write the names of any two food items that assist to protect the body by increasing immunity. b. Deficiency of which vitamin causes wasting? c. Which disease causes inability to see in dim light? d. Write one of the ways to protect nutrients during cooking. 24 Health & Physical Education, Class-8

Unit 4 Disease Introduction The physiological condition in which the body organs or system do not function properly and uneasiness emerges in the body is called a disease. It is affected by the location, food habits, cleanliness, personal behaviour and religious or cultural environment. A disease is caused by unhealthy behaviour, polluted environment, deficiency of nutrients and bacterial or viral or parasitic infection in the body. The diseases are classified into two types. They are: communicable disease and non-communicable diseases. Communicable Disease The disease that can transmit/communicate from one person or animal to the other by means of various germs is known as a communicable disease. Preventive measures of communicable diseases a. Use of Safe Drinking Water Water is used in everyday activities. It is used for drinking as well. If the water we drink is not pure or safe, the diseases such as diarrhea, whines, dysentery, cholera, etc. can easily infect our body. Clean water is needed for taking bath, washing, cooking, drinking, cleaning, etc. b. Safe and Balance Diet Food that is consumed daily must be fresh, hygienic and balanced. Such type of food helps to develop our physical, mental, social and emotional aspects. Lack of nutritious food may cause various diseases such as marasmus, wasting, night blindness, anaemia, etc. Therefore, in order to be safe from various communicable diseases and malnutrition, the food should consist of all nutrients and it should also be clean, fresh and hygienic. Health & Physical Education, Class-8 25

c. Cleanliness We cannot be healthy in absence of personal and environmental cleanliness. Due to insufficient cleanliness, people suffer from various communicable diseases such as diarrhea, dysentery, cholera, etc. We have to be very much aware of our own personal and environmental cleanliness. We have to make our surroundings and sources of water clean. d. Immunization Our body has capacity to fight against causative agents of diseases. This is called immunity. Diseases attack in case of insufficiency of nutrients, ignorance towards diseases, lack of environmental cleanliness and lack of timely vaccination as required. Therefore, the vaccination should be as mentioned in the table given below. Name of Name of Time Quantity/ Vaccination Dose vaccine disease dose interval B.C.G Tuberculosis Within one year Once - from birth D.P.T Diphtheria Within six weeks Three times With the interval Pertussis to one year from of four weeks Titanus birth from the first vac- cination. 26 Health & Physical Education, Class-8

Polio Polio Within six weeks Three times Within the inter- drops to one year from val of minimum birth four weeks from the first vaccina- Measles Measles Within 9 months Once tion T.T. Tetanus to one year Five times - For pregnant and other women The second after aged between 15 four weeks from to 44 years. the first, then next after six months, the third after one year and last one after next one year. e. Use of Toilet and Formation of Open-Defecation Free Community The main source of communicable diseases is human defecation. If we defecate in the open places, the bacteria as well as parasites mix in the soil, water and air which finally pollute the environment. Therefore, in order to manage stool and urine properly, we have to use the toilets compulsorily. Some Communicable Diseases 1. Meningitis The brain and spinal cord are covered by a type of membrane which is called meninges. The inflammation in the same meninges is known as meningitis. Although, this disease can be found in people of all ages, it communicates very quickly among children. This disease is caused by the bacterium named Neisseria meningitides. This disease may communicate through kissing, sexual intercourse, or frequent attachment with the patient. Some of the symptoms of this disease are: high fever, vomiting, neck stiffness, headache, etc. Similarly, the patient may shiver, faint and in the case of babies under 18 months, swelling of palate may be the symptom. Preventive Measures a. Keep the patient in a separate room (Isolate the patient). Health & Physical Education, Class-8 27

b. Use the clothes, utensils, etc. used by patient after washing them with soap properly. c. Dispose or bury the things used by the patient. d. Visit health centers for check-ups immediately. e. Have immunization against this disease and aware people to prevent them from this disease. 2. Encephalitis Encephalitis is also called zoonotic disease. This disease appears most often in the Terai region of Nepal during summer. This disease is caused by J.E virus that falls under the class of B. Arbo virus. Some of the symptoms of this disease are: sudden high fever, headache, sore and painful throat, vomiting, fainting, loss of memory and consciousness, paralysis of the muscles of hands and legs, etc. At first, this disease spreads in animals and birds. Later, this is communicated to humans by a type of female mosquito that belongs to culex. Culicine bite causes swelling of the membrane in the brain. The incubation period of this disease ranges from 5 to 15 days. Preventive measures a. Go for immediate treatment as soon as the symptoms are noticed. b. Use mosquito nets or keep nets in the windows in order to protect yourself from the mosquitos. c. Keep pig farms away from home and manage them properly. d. Use vaccines against this disease. Activity What are your family members or neighbours doing in order to avoid mosquito bites? Make a list of the activities that you have seen or done and share it with friends. 28 Health & Physical Education, Class-8

3. Hepatitis-B Hepatitis –B can transfer from one person to another through air, blood, sexual intercourse, sharing syringes of drugs, remains of patient’s food, utensils used by patients, etc. This disease affects the patient’s liver and leads to death. Most often this disease affects the people between 20 to 40 year of age. The incubation period of this disease ranges from 6 weeks to 6 months. Symptoms a. Loss of appetite and vomiting, b. Weakness in the body, tiredness and fatigue, c. Yellowing of organs such as nails, eyes, skin, etc, d. Swelling of liver and abdominal pain just below the right part of the chest, e. Liver cancer that may lead the patient to death, Preventive measures a. Blood transfusion only after proper examination. b. Use of patient’s belongings only after cleaning them. c. Reuse equipment or syringes only after sterilization. d. Vaccination against hepatitis in time. e. No consumption of tobacco, alcohol, and drugs. In case of any doubt of the disease, visit health centers for check-up. 4. HIV and AIDS The immunity power of the body is destroyed once a virus named Human Immuno- deficiency Virus (HIV) enters the body. Various diseases may affect due to this reason. This condition is known as AIDS (Acquired Immmuno-deficiency Syndrome). Till now, the medicine for the complete treatment of HIV or AIDS has not been invented. There are three stages of this disease. They are: HIV infection, HIV positive and AIDS. No symptoms are found during the early period of HIV infection. Gradually, the symptoms are visible. Eventually, the disease cannot be treated and the patient may die. Health & Physical Education, Class-8 29

Modes of transmission a. Through unsafe sexual intercourse with HIV infected person b. Through the use of unsterilized syringes and other equipment c. From a HIV infected mother to her baby d. Through the transfusion of blood or transplantation of any other organ of HIV infected person to other healthy persons Major Symptoms a. Weight loss of more than 10% in a month b. Diarrhea for three weeks or more c. Recurring fever for more than one month d. Delay in healing wounds or injuries e. Genital Herpes (Janaikhatira) Preventive measures a. We should avoid unsafe sexual intercourse. b. Blood transfusion and organs transplantation should be done only after blood test. c. We should avoid conception by HIV infected women. d. We should use only sterilized syringes and other equipment. e. We should avoid drug addiction/substance abuse. Some Non-communicable diseases 1. Asthma A chronic disease that causes difficulty in respiration is known as asthma. The dust, smog, polluted air, etc. cause difficulty in respiration. Insufficiency of oxygen level in the body causes rapid and labored respiration. If we can live a healthy personal life, we can prevent and control this disease. 30 Health & Physical Education, Class-8

Causes a. Due to allergy to various things, b. Consumption of drugs and tobacco, c. Exposure to cold air and mental stress , d. Cardiac problems, e. Cold or frosty environment, f. Dust, smoke, dirt, etc. Symptoms a. Cough, shortness of breathing and difficulty in breathing, b. Rapid and labored respiration while walking or working, c. Feeling of tightened chest and rapid heartbeat, d. Physical weakness. Preventive Measures a. Being away from cold environment, cold food and smog, b. Identifying and avoiding the things that are allergic to the body, c. Early treatment of common cold (flu), pneumonia, tuberculosis, etc. d. Avoiding consumption of tobacco, alcohol, and drugs, e. Reducing mental stress and increasing public awareness towards asthma. f. Stay free from dirt, smoke and dust. 2. Stones Stones may be formed in various internal organs of our body such as kidneys, gall bladder, urinary bladder, etc. This is one of the health problems and is known as stones. The stones are formed by excessive concentration of cholesterol, calcium and salt in our body. Health & Physical Education, Class-8 31

Causes Dehydration and consumption of excessively spicy food items are the primary causes of stones. Symptoms a. Loss of appetite and indigestion, b. Blockage in the urinary tract and bile duct, c. Swelling and pain in the place where stones are formed, Preventive Measures a. Reduction in the consumption of salt, oil and spicy food, b. Drinking sufficient amount of water, c. Regular physical exercise , d. Immediate treatment of stones after it is suspected or diagnosed. 3. Cancer Cancer is the disease condition of excessive or unnecessary growth of cells in the body. This disease most often attacks people above 40 years of age. It can be treated if it is diagnosed in its early stage. Causes a. Excessive consumption of tobacco, alcohol and drugs, b. Polluted environment, c. Consumption of oily and spicy food, d. Lack of timely treatment of wounds or injuries, e. Due to the effects of heredity, poisonous rays and adulteration. Symptoms a. Appearance or formation of lumps in various parts of the body, 32 Health & Physical Education, Class-8

b. Wounds or injuries that won’t heal for long time c. Change in the colour and size of the moles or warts d. Bleeding even after menopause e. Change in the voice and hoarseness f. Appearance of blood in the stool, weight loss without any reason and weakness Preventive Measures a. We should avoid consumption of food items grown or protected using chemicals. b. We should avoid taking tobacco, alcohol, and drugs. c. We should go for immediate check-up in case of the appearance of lumps and any other wounds or injuries in the body. d. We should increase public awareness against cancer. 4. Diabetes Diabetes is a disease caused by increment of blood glucose due to deficiency of insulin secretion by pancreas gland in the body. This is also known as sugar disease. This disease most often attacks the obese people and the people not have necessary physical exercise. It is seen in the people above 40/45 years of age. It can also be seen in any age if there is malfunctioning of pancreas. Causes The main causes of diabetes include heredity/genetics, passive or inactive life style, obesity,functional inability of the pancreas, etc. People having insufficient physical labour, mental stress and anxiety suffer from this disease. Malnutrition may also be one of the causes of this disease. Symptoms a. Increased thirst and hunger b. Gradual loss of weight Health & Physical Education, Class-8 33

c. Frequent urination, d. Blurred vision, e. Increment of glucose level in blood, f. Tingling in the hands, legs and the whole body, sometimes leading the patient to be faint . Preventive Measures a. Low consumption of oily, sweet and spicy food, b. Regular physical exercise, c. Early treatment of the wounds or injuries , d. Avoidance of mental stress, e. Immediate treatment after diagnosis 5. Heart Diseases i. Heart Attack Heart attack is caused by the blockage of blood circulation due to narrowing or blocking of coronary arteries in our body. If there is formation of fat in the coronary artery or blood clotting in the veins of the heart then this causes heart attack. This disease mostly found in people above 40 years of age. Causes Modern life style, mental stress, diabetes, high blood pressure, excessive smoking, alcoholism, obesity, genetics, etc. are the causes of heart attack. Symptoms a. Pain in the middle of the chest and excessive cold sweating, b. Difficulty in breathing, c. Sudden increase in blood pressure and thirst, d. Rapid and difficult respiration, nausea and unsteady heart, e. Pale, rubbernecking eyes and faint. Health & Physical Education, Class-8 34

Preventive Measures a. Regular physical exercise, b. Controlling weight, c. Avoiding stress, d. Increasing the consumption of green vegetables and fruits, e. Regular health check-up to confirm that the pressure is at normal level,. f. By not smoking. ii. Hyper Tension The maximum arterial pressure that occurs during contraction of the left ventricle of the heart is known as systolic pressure and the minimum pressure that occurs during ventricular diastole is known as diastolic pressure. The proportion of systolic and diastolic pressure remaining 120/80 mm Hg is assumed as normal pressure. The pressure of more than this range is taken as high hyper tension. Causes a. High consumption of salt, b. High consumption of oily substances, c. Smoking, alcoholism and drug addition, d. Obesity, increased weight, e. Living unhealthy life style, f. Increased mental stress, g. Genetics. Symptoms a. Headache, chest pain and dizziness b. Sleeplessness and high temper c. Sensation of unsteady or quaking heart and sweating Preventive Measures a. We should do regular physical exercise. b. We should decrease obesity. Health & Physical Education, Class-8 35

c. We should avoid consumption of tobacco, alcohol and drugs. d. We should increase consumption of green vegetables and fruits. e. We should decrease consumption of salt. f. We should go for immediate treatment after appearance of the symptoms. iii. Rheumatic Heart Disease Among various heart diseases, rheumatic heart disease is one of them. This disease is frequently found in the children between 3 to 15 years of age. In the beginning of this disease, tonsillitis and pharyngitis may be observed. The patient may suffer from fever after one to four weeks of frequent pain in the throat. This is known as rheumatic fever. At this time, along with the fever, the patient may feel joint pain and swelling as well. This disease is caused by bacteria called Beta hemolytic streptococcus. Group - 'A' more than 50% of the children suffering from rheumatic fever have problems in their valves in the heart so that this disease is called rheumatic heart disease. The early symptoms of this disease include painful throat, loss of voice, fever, etc. We have to consult for treatment immediately after these symptoms. Activity What changes do we need to bring in our daily activities and food habits in order to avoid heart related diseases? Discuss with your friends in your classroom. Summary A disease is a body condition in which a person becomes unable to carry out daily activities, feels unhealthy, and the body organs and systems cannot function properly. The diseases are of two types: communicable and non-communicable. To keep ourselves away from the diseases, we have to pay special attention to our food habits, physical exercise, personal and environmental cleanliness, healthy behaviour, vaccination, etc. The disease that can communicate to an individual through different means is called a communicable disease. For example, meningitis, encephalitis, hepatitis, HIV/ AIDS, etc. The disease that emerges from the body itself due to various causes is known as non-communicable disease. 36 Health & Physical Education, Class-8

Exercises 1. Fill in the blanks. a. The main cause of meningitis is…………….. b. …………….disease is caused by ‘Group B Arbo’ virus. c. High blood pressure is a disease related to……………. d. The unnecessary growth of cells in the body is called …………. e. …………. cannot be diagnosed within some weeks or months the HIV enters the body. 2. Write one-word answer to the following questions. a. What is the main cause of HIV and AIDS? b. What is the name of the disease caused by increased level of glucose in our blood? c. What is the normal proportion of the systolic and diastolic blood pressure in our body? d. What is the health problem caused by formation of stone in kidney, gallbladder, urethra, urinary bladder, etc. in our body? e. What is the name of a chronic disease related to lungs that causes difficulty in respiration? f. What is the condition of the defects in the valves of the heart called? 3. Give short answer to the following questions. a. What are the symptoms of Hepatitis B? b. What are the causes of Cancer? Health & Physical Education, Class-8 37

Unit Adolescent Sexual and 5 Reproductive Health Responsibilities of Adolescents According to World Health Organization (WHO), the persons belonging to the age between 10 to 19 years are adolescents. In this span, rapid changes in physical, mental, emotional and social aspects take place. This is the foundation stage for adulthood. The developments in this stage can be taken as the bases for prediction of personality of an individual in the future. Therefore, it is a very important stage in life. In this stage, a person is to be responsible for his/her own family, society and the nation along with his/her personal responsibilities. 1. Personal Responsibilities a. Working hard in study or learning, b. Taking care of self-health and hygiene, c. Avoiding addiction and engaging oneself in creative activities, d. Following guidance and advice of parents or guardians while carrying out any new task. 2. Family Responsibilities a. Carrying out tasks following the advice and guidance of the family. b. Taking care of health of the family members and creating peaceful and cooperative family environment. c. Encouraging for healthy family health and discouraging superstitions . d. Assisting the parents in their household and professional activities. e. Respecting elders and extending love to the youngers. f. Making your parents feel proud of you. Health & Physical Education, Class-8 38

3. Responsibilities towards the society and the nation a. Adopting healthy behaviour and assisting others to do so b. Respecting the social norms and values, c. Participating in the social and cultural activities , d. Raising awareness against superstitions that are rampant in the society, e. Playing leadership roles to discourage social evils, f. Contributing to the formation of a healthy and peaceful society, g. Participating voluntarily in social services , h. Forming bases for the nation to be proud of you . Safe Sexual Behaviour During adolescence, there is rapid growth of sex organs due to secretion of various hormones. Naturally, the sex desire increases due to these hormones. But it is important to manage this desire. The desire and the activities related to sex are collectively called sexual behaviour. If there is safe sexual behaviour, the health and the social reputation will not be damaged. People who are unable to adopt safe sexual behaviour become the victim of life-threatening diseases such as AIDS. Some of the people have died due to unsafe abortion and some others have been living in the prison because of violating the law. Measures for Safe Sexual Behaviour (Unsafe sexual behaviour means having sex with more than one, premature sex and the sex having without using condom.) a. Developing tolerance and mutual understanding, b. Having sexual relation only with a trusted sex partner, c. Using condoms properly while having sexual intercourse, d. Avoiding sexual relation with the people infected with sexually transmitted, diseases and undergoing immediate treatment in case of such diseases, e. Appreciating the natural changes visible in the sex organs, f. Avoiding sexual relation that are against the established social norms and values Health & Physical Education, Class-8 39

Reproductive Health Reproduction refers to the process of producing children. Reproductive health is a state of physical, emotional, mental and social well-being in relation to reproductive system, reproductive organs and their functions. In other words, it includes all the aspects of health related to reproductive system and its functions. Therefore, reproductive health deals with ability to live a safe sexual life, ability to make reproduction, and freedom to decide when and how to do so. Concept of Safe Abortion The abortion that is carried out by a licensed health practitioner in the licensed organization taking consent of the pregnant woman is known as safe abortion. Sometimes, there may be unwanted pregnancy. In such cases, the pregnancy is to be terminated which we call abortion. Safe abortion service procedure (2060) mentions that abortion can be done in case the pregnancy is harmful to the pregnant woman's physical and mental health and the fetus is suffering from a severely debilitating or fatal deformity as certified by an expert physician. The abortion of the fetus up to 12 weeks of gestation and up to 18 weeks of gestation in case of rape or incest can be done without recommendation from a physician. But it is good if the physician is consulted. Abortion can be done on request of the pregnant woman but in case the woman is unconscious or is below age 16, then consent must be taken from her parents. Prohibition of Abortion a. Compelling a woman to abortion through cheating or forcing is strictly illegal and is prohibited. b. Abortion is not allowed after identification of sex of the fetus. c. Abortion is not allowed in any other case except in the condition or time as mentioned in the law. Risks of Unsafe Abortion Nepal Government has made a legal provision for safe abortion. However, being 40 Health & Physical Education, Class-8

unaware of this provision many women go for an unsafe abortion. This may claim their lives too. They have been facing different problems due to abortion without matured advice from the physicians. Their health may further be deteriorated due to carelessness even after abortion. The following are the problems of unsafe abortion. a. Incomplete abortion resulting excessive bleeding may cause threat to life b. Infection and injury in the uterus may invite surgical removal of uterus, c. Probability of infertility, d. Prolonged lower abdominal pain, e. Death Methods of Safe Abortion a. Safe abortion can be done through medical abortion (using medicines) for the fetus of 9 weeks (63 days) or below. b. Safe abortion can be done through the use of abortion tools and instruments for the fetus of 12 weeks or below. Concept of Birth Control, Methods and Tools Fertilization refers to the process of formation of zygote through the combination of sperm of males and ovum of females. The process of preventing the formation of zygote is known as birth control. The couples control birth if they are not willing to have a baby. Methods of Birth Control 1. Temporary Methods of Birth Control a. Natural Methods There is low probability of ovulation in the breast-feeding women. So, it may be safe having sexual intercourse during this time. Similarly, other natural methods include test of menstrual bleeding, withdrawal method, rhythm method, temperature test method, etc. Health & Physical Education, Class-8 41

b. Artificial Methods i. Implant The health workers put two small, thin, flexible hormone capsules under the skin in the arm of the women. This hormone prevents fertilization by deactivating the ova. This works for five years once it is implanted. There are two types of implants on the basis of the time duration they function. They are: 3-year implant and 5-year implant. ii. I.U.C.D. (Copper-T): Inter Uterine Contraceptive Device (IUCD) is a small device made up of plastic and copper with the shape of English letter T. It is put in the uterus by health professionals. This device disables the meeting of spermatozoa with ovum and it prevents fertilization. iii. Depo-Provera: Depo-Provera is a contraceptive method for women. It's made of a hormone similar to progesterone. This is an injection, given to the females on arm or buttocks. This injection should be given once in every 3 months. It stops the meeting of ovum and spermatozoa. iv. Pills: Pills is the birth control medicine in the form of tablets that women take one pill per day. This type of medicine inhibits ovulation and prevents fertilization. v. Condom: Condom is a kind of soft plastic sac. This is of different shapes for both males and females. The condoms used by males covering their penis during sexual intercourse prevent seperate semen from entering the uterus so that fertilization is not possible. Similarly, the female condom is kept in the vagina and it bars the sperms from meeting egg and the fertilization is prevented. A female condom is called Femidom. 42 Health & Physical Education, Class-8

Emergency Contraception In case of emergency conception, an emergency birth control method may be adopted. This can be done by taking the medicine named E-con or I-pill within 72 hours of sexual intercourse. These types of medicines should not be used frequently. 2. Permanent methods of birth control a. Vasectomy In vasectomy, the vas difference is cut and tied in order to block the sperms coming out and mixing in semen. In doing so, the sperms cannot enter the uterus so that conception cannot take place. This is the permanent method used for males only. Vasectomy Mini-lap b. Mini-lap and Laparoscopy The eggs developed in the ovary arrive at the uterus through the fallopian tube. In minilap, the fallopian tube is cut but, in laparoscopy, it is tightly tied. This method blocks the eggs to pass into the uterus and conception is avoided. This is permanent birth control method for females. Reproductive Health Services and Facilities The services related to the promotion or enhancement of reproductive health are called reproductive health services. Every government provides this type of service to its people. The non-governmental organizations also provide these services. The governments and non-governmental organizations provide the following type of reproductive health services and facilities. Health & Physical Education, Class-8 43

a. Care for pregnant women, b. Counseling about birth control and distribution of contraceptives, c. Control and treatment of sexually transmitted diseases, d. Legal rights for safe abortion and availability of the services for this. e. Maternity services and safe motherhood services, f. Management of reproductive health education, g. Measures for emergency birth control. Introduction to Comprehensive Sexuality Education, its Importance and scope Sexuality includes opinions, values, norms, attitudes and behaviour related to sex. Sex education refers to the process of making logical change in the existing knowledge, attitudes, skills and behaviour towards sexuality. The main aim of sex education is to enable people for living physically, mentally, emotionally and socially healthy sex life. So this education aims at advocating on youth-friendly health service, safe sexual behaviour, safe motherhood and respecting to the rights for reproduction and its promotion. Importance of Comprehensive Sexuality Education a. It provides positive attitude, useful knowledge and skills b. It provides information related to sex and rights to reproduction. c. It develops awareness against gender violence d. It helps to find out the ways to strengthen interpersonal relations and the skills necessary for it. e. It addresses the queries and problems related to sexuality. f. It contributes to the wider nation building by helping to maintain personal health, family health and community health as well. 44 Health & Physical Education, Class-8

Aspects of Sex Education 1. Sex and reproductive health: The comprehensive sexuality education attempts to assist each individual maintain healthy sexual and reproductive sexual behaviour. It informs the people about healthy conception, birth control, safe abortion, and preventive measures from sexually transmitted diseases. 2. Gender Gender refers to the roles and behaviour decided socially and culturally for both males and females. Various measures are adopted in order to avoid gender based violence. 3. Violence Violence refers to the condition in which a person behaves making physical and mental offence to the other person. 4. Sex right of each citizen Every individual has the right to make gender identity based on his/her willingness. Everyone can identify as being male, female or third gender. So the exercise of the rights to make sex identification, its protection and promotion belong to the domains of this education. 5. Recreation and entertainment Every individual is free to take the joy through sex. All the ways including sexual intercourse in order to enjoy sexually fall under this domain. 6. Diversity Every individual is different. Such differences may be physical, financial, religious, cultural, etc. Similarly, they may be males, females or third gender. Health & Physical Education, Class-8 45

7. Relation Everyone has the right to establish familial and personal relationship with any other person. We have to avoid conflict amongst ourselves. There must be mutual respect in order to make the relations long lasting. Activity What are the ways of adopting various methods of birth control, their advantages and disadvantages? Discuss in your class Summary - According to WHO, people with the age range from 10 to 19 years are called adolescents and this span is adolescence. The adolescents have a lot of responsibilities to their family, society and the whole nation along with their own personal responsibilities. - The abortion that is carried out by a licensed health practitioner in the licensed organization taking consent of the pregnant woman is known as safe abortion. - Sexuality includes opinions, values, norms, attitudes and behaviour related to sex. Sexuality education refers to the process of making logical change in the existing knowledge, attitudes, skills and behaviour towards sexuality. Exercises 1. Fill in the blanks. a. Maintaining personal health care and hygiene is ……….. of the adolescents. b. Nooneisobligedtomake…………..bythreatening,fearorbyanyotherforceful means. c. We can prevent conception by taking …………………within 72 hours of unsafe sexual intercourse. 46 Health & Physical Education, Class-8